A variety of medical implants include a length of elongated material, such as tubing or wiring. For example, implanted pumps may include a length of tubing extending between the pump location and the desired delivery point, wherein the tubing serves to convey a prescribed dosage of medicine, such as pain killer, to a portion of the patient's body. As another example, electrical stimulation sources or pulse generators are used in combination with electrodes to provide electrical stimulation of nerves for the treatment of pain. As further background to existing treatment systems, reference is made to U.S. Patent Application Publication No. 2005/0010259 that discloses electrical stimulation and drug therapy systems, and the content of the aforementioned application is incorporated herein by reference in its entirety.
In general, because of its size, a pulse generator is typically separated from the electrodes that actually deliver the electrical stimulation to the target area, where the target may be the spinal cord or its peripherhal nerves, or other body locations, such as the head or legs. More particularly, a length of wiring or lead is implanted and extends between the pulse generator and the electrodes placed at the target location, wherein the electrodes are interconnected to the lead using a coupling, or alternatively, the electrodes may be integrally formed at the end of the lead itself.
Leads typically are supplied by a medical device manufacturer, and therefore, are available pre-made and can include wiring for an electrode array. More particularly, leads typically contain a plurality of conductors leading to a coupling or corresponding number of electrodes that may be separated at the distal end of the lead. Such configuration allows electrical stimulation to be provided over an area rather than at one specific point. Referring to FIG. 1, a neurostimulator 102 is shown that includes a lead 106 and a pulse generator 110. The lead 106 has a distal end 114 that typically comprises a plurality of electrodes 118. The proximal end 122 of the lead 106 typically is adapted for mating with the pulse generator 110. Because the structure of the lead 106 has a plurality of conductors leading to a plurality of electrodes 118, a surgeon typically does not modify the length of the lead 106 because of the difficulty that would be associated with trying to splice the different conductors together. Accordingly, the surgeon typically uses the lead 106 as it is manufactured, and does not modify its length.
During the course of a surgical procedure to implant a neurostimulator 102, the surgeon will implant the pulse generator 110 in an appropriate body location, such as the upper chest, buttock or abdomen of the patient. The surgeon will also implant a lead 106 and electrode 118 and connect the lead 106 to the pulse generator 110. The surgeon chooses the length of the lead 106 based upon the patient's size and perhaps other factors, such as patient growth, but must choose a lead length that is at least long as the distance between the pulse generator 110 and the electrode target location. The excess length of the lead 106 is then typically inserted or tucked into the patient's body at one of the incision locations. As discussed further below, it is this last step that poses several problems.
One issue associated with the excess length of the lead is that, since the surgeon must essentially push the excess length into the incision, the wiring of the lead can sometimes become kinked and damaged, thereby requiring replacement. In addition, the excess length can create an unsightly appearance under the patient's skin, and may some times bulge. This can detrimentally impact patient satisfaction and can also negatively influence cooperation with the treating physician. Also, if the surgeon must replace or augment one or more components of a previously implanted system, the wiring must be dissected from tissue that has grown around its length. Accordingly, if the wiring is looped and/or otherwise awkwardly positioned, then subsequent removal of the wiring can be more difficult than a neatly situated lead. Therefore, it would be advantageous to provide a device and method for use that allows a surgeon to utilize pre-manufactured leads and organize excess length of such leads within a surgical site.